1 + 1 = 3

I often hear from frustrated parents, “My child knows A, my child knows B, so why on earth can’t she make a sentence with A and B together? I’m pulling my hair out!” Moving from single words to phrases of two words or more is a significant milestone in language development. How do we help children achieve this goal?

Generally, we see a leap to two-word combinations when a child has a functional vocabulary of approximately 50 words. For a typically-developing child, the mean (average) age for this to occur is around 19.75 months*. Not every two-word combination is the same, and they come in many different forms:

agent + action (Mom push)

action + object (push car)

action + recipient (kiss Dad)

entity + location (shoe [is under the] chair)

attribute + entity (blue car)

possessive + entity (my car, Mom[‘s] hat)

negative + X (no bath)

introducer + X (look [at the] cat)

As you’ll see from the list above, many of these two-word combinations seem like telegraphic speech. They leave out important small words, like “the” or a possessive “-‘s”. At this language stage, that is developmentally appropriate.

So why, if the child has the basic vocabulary, is it so difficult to combine those words into first phrases? As I explain it to parents, it’s not always a case of 1 + 1 = 2. Here, it’s more like 1 + 1 = 3. It’s one thing to know each word (1 and 1), but that “+” is the complicated cognitive step of realizing that words don’t happen in isolation. They can relate to each other and be combined to show a different meaning. First, children learn that a word (a combination of sounds) stands for some object. Then, they learn that combining two of those sound patterns (those words) together makes the words have a relationship with each other and can change the meaning entirely (e.g. “blue car” means something very different than “blue hat”). It’s a big leap!

This stage is so exciting, but it can also be slow going. How can we help?

Check the child’s play skill development. If a child is combining two objects in play (e.g. putting the cow in the barn, using a spoon to “feed” a baby doll), this is a good sign that she’s developmentally ready for this language task. If she’s not, create some play scenarios where you can help scaffold and develop this skill.

Be patient. Just like that first vocabulary of 50+ words didn’t happen overnight, combining them won’t either.

Give lots of practice and examples. The same way you used repetition and acoustic highlighting and fun, engaging activities to teach first words, you can teach first word combinations. Repetition is key, but read these tips to keep it from becoming rote or boring.

Use acoustic highlighting. If the child misses one of the words in the phrase, highlight it acoustically by giving extra emphasis, changing the volume or intonation of your voice, or slowing down your rate of speech.

Give choices and sabotage. If there are two plates, a blue one and a red one, the child has to specify which he wants. “Plate!” just won’t do it, you have to ask for the blue plate or the red plate. Likewise, use sabotage (or deliberately playing dumb, getting things wrong, and being silly) to encourage the child to expand. Hold up one of his shoes and say, “Is it my shoe?” (when it’s obviously not and too small for you) to encourage him to use the possessive + entity phrase, “No! My shoe!“

Model correct grammar. Even if our goal is for the child to just say “Mama hat” (for the possessive + entity phrase), we will still model the grammatically correct phrase, “Mama’s hat.*” The child might omit the possessive “-‘s”, and, as mentioned above, that’s completely fine, but we always want our model to the child to be as complete and correct as possible. It can be very tempting to slip into abbreviated speech and model only the words that we want the child to say, but we have to keep in mind our long-term goals. We don’t want him stuck at the “Mama hat” stage forever, so we shouldn’t speak to the child as if we do. Listeners at this age will pick out the relevant words to them and repeat back those two “power words” that they hear. Don’t worry that adding things like “a” or “the” will throw them off. (*Please note that for some dialects of English, “Mama hat” is in fact a grammatically correct and acceptable phrase for adult speech. See this article for more information on honoring diverse family dialects in therapy.)

Make sure both words are familiar. Remember the principle of Just One Hurdle. If we’re asking a child to make a two-word phrase, I want her to be very, very comfortable with each word individually so she can focus only on the phrase-building task. If I’m asking a child to produce the phrase “subdural hematoma” (aka a bruise… and yes, this is an attribute + entity phrase just as much as “blue car” is), but both of those words might as well be in Chinese to her, we’re over-complicating the task.

Say the whole phrase. We know the child can say “eat” and we know the child can say “dog,” so if we’re trying to tell the stuffed puppy to eat his meal (“Dog, eat!”), it doesn’t help us to have her imitate one word at a time (“Say ‘dog'” “Dog” “Say ‘eat'” “Eat”). We already know she can do that! If the parent says, “Dog, eat!” to tell Fido it’s time for dinner, and the child says back, “Eat!”, instead of supplying the words one at a time, we should repeat back the whole model with emphasis on the missed word. Again, we know she can imitate single words, but that is not our goal. To teach phrases, model phrases.

So what kinds of activities work to teach each of these phrases? The possibilities really are endless. You are only limited by your creativity, but here are some of my favorites:

Agent + action. Have a ball!Get out a ball (or two, or three). Who should kick the ball? (Mama kick). Who should throw it? (Daddy throw.)

Entity + location. It’s time for hide and seek! Hide various items around the room and talk about where they are. [The] ball [is under] the chair. [The] hat [is on] the table. [The] teddy bear [is behind] the couch.

Attribute + entity. Let’s do laundry! I can find a blue sock, a red shirt, a white skirt, etc.

Possessive + entity. Sort the laundry! This is my shirt, this is Daddy’s sock, this is Mommy’s scarf.

Negative + X. Take three opaque cups and a few small toys. Show the child a toy and then tell him to close his eyes and hide it under one of the cups. Lift up each cup: “No cow… No cow… Here’s the cow!” This game is great because it’s super simple but fits in nicely with both cognitive and language development goals for children at this age/stage. Try it. You’ll be amazed how fun they think it is!

Introducer + X. Put some pictures on the wall and “spy” them with a flashlight. “Look, [a] cow!” “Look, [a] sheep!” Go for a walk and point out things you see on the way. “Look, [a] dog!” “Look, [a] bird!”